If your high blood pressure can be caught in its mildest stage, and you happen to have no other red flags, as identified by your doctor, such as diabetes, “bad genes,” old age, male sex, stressful lifestyle, smoking, alcoholism, kidney disease, obesity, elevated “bad cholesterol,” stroke, or other coexisting or past health conditions (that make any persistent BP elevation relatively risky and therefore worth robustly controlling), the first line of defense would not be outright medication (and nope, not pineapple juice). It is to look at the larger picture; that is, to identify other contributing factors in your life that are associated with hypertension, and try to modify them.
But after lifestyle resolutions have been said and done, it’s down to the maintenance meds. There are many types of drugs to control hypertension. Usually your doctor chooses one that is most effective for you—it should have the fewest and mildest side effects. It may have additional benefits aside from effectively controlling your BP. For example, people with kidney problems caused by diabetes might benefit from the use of the so-called ACE inhibitors and angiotensin II receptor blockers (the “-pril” and “-sartan” drugs, respectively), as they help delay the worsening of kidney disease. Diuretics or water pills are also good for people with edema or body swelling caused by water retention, as they help excrete excess body water through the kidneys.
Your doctor may also switch your regimen between different types of meds, combine them, change their dosage, or discontinue them, depending on your response, emerging side effects, existing medications, among other factors. Other drugs for hypertension include beta blockers, alpha blockers, calcium channel blockers, renin inhibitors, direct vasodilators, and centrally-acting antihypertensives. They are best explained by your doctor.
Should your doctor ever decide to start you on antihypertensive medication, ask for an explanation. Ask the questions nagging you. Be curious. Communicate openly. Ask your doctor how to empower yourself with self-care. Heed his advice. You know better: dialysis doesn’t rhyme with happiness; stroke spells broke; and you can’t have a family kickback with a heart attack.